Paroxysmal supraventricular (atrial) tachycardia PSVT

• Facts:
  Supraventricular tachyarrhythmia
  MC mechanism underlying PSVT is re-entry into the AV node
• History / PE:
  Palpitations
  SOB
  Angina
  Syncope
• Diagnosis:
  Rate > 100 bpm, REGULAR
  P wave with an unusual axis before normal QRS
• Treatment:
  Goal is to decrease AV nodal conductivity
  
  Vagal maneuvers (Valsalva, carotid sinus massage, immersion in cold water) increase vagal tone, and decrease conduction through AV node
  
  Adenosine (unmask atrial activity)